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General NPI Number Information
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NPI Number | 1104800432
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Entity Type | Individual
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Provider Name | WALEED MUGALLY SAIDI DDS
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Gender | Male
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Dates
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Enumeration Date | 11/30/2005
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Last Update Date | 04/18/2012
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Provider Practice Location Address
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Address Line | 3003 30TH AVE STE 2 DENTAL SMILE PC
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City | ASTORIA
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State | NY
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Zip | 11102-2168
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Country | US
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Telephone | 917-582-0802
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Fax | 917-582-0802
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Provider Business Mailing Address
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Address Line | 132-41 114 PL
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City | SOUTH OZONE PARK
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State | NY
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Zip | 11420
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Country | US
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Telephone | 917-582-0402
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 050236
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License Number State | NY
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